WHO, Others Pledge to End Cholera.

The World Health
Organization is sending 900,000 doses of cholera vaccine to Bangladesh to help
prevent a major outbreak of cholera in the crowded Rohingya refugee camp that
sits on the border of Bangladesh and Myanmar. At least a half-million Rohingya,
a Muslim minority in Myanmar, have crossed the border to escape a military
crackdown in their villages.

In Yemen, a
massive and deadly cholera epidemic has affected almost 800,000 people, and the
World Health Organization expects that number to climb to 1 million by year's
end. Worldwide, about 100,000 people die from cholera each year. On Tuesday,
the WHO, along with governments, aid agencies and donors announced a roadmap to
end cholera by 2030. It’s the first global pledge to end this disease.

Dr. Amesh Adalja
said it’s not possible to eliminate cholera because cholera is a bacteria that
exists naturally. Adalja is an infectious disease expert at the Johns Hopkins
University Center for Health Security. He is also a fellow of the Infectious
Diseases Society of America.

Adalja told VOA
it is possible to make cholera as rare in Bangladesh and in Yemen as it is in
the United States and the rest of North America. He said sanitation is the key
to eliminating cholera. The disease is “not something that should happen in
2017,” Adalja said. “This is something that can be fixed by development and the
civilizing effect of sanitation.” Cholera is a diarrheal disease. The bacteria
that causes cholera lives in coastal waters and in brackish rivers. It thrives
where there is poor water treatment, poor toilet sanitation and poor hygiene.
It’s caused by eating or drinking contaminated food and water.

Malnutrition plays
a role

Malnutrition is
also a factor. Jesse Hartness is the senior director of emergency health and
nutrition at Save the Children, an agency that has been working to control the
cholera outbreak in Yemen. “There’s a cycle of illness and malnutrition where
you have a child who is sick, and they lose their appetite,” Hartness said.
“They are dehydrated from having diarrhea, they lose weight, and, once they are
malnourished, that also drives their vulnerability to additional illness.”

Anyone can get
cholera, but children, pregnant women and the elderly are most at risk.

Yet, cholera is
not difficult or expensive to treat. Hartness said it is simple if the disease
is caught early and if you can provide hydration to the less severe patients so
they don’t become severe patients who require more intensive treatment. But in
places ravaged by flooding and other natural disasters, or by manmade disasters
like war, or in crowded refugee camps, sanitation is hard to maintain. Water
can’t be treated properly. Human waste can’t easily be disposed of
hygienically, so in addition to providing aid, organizations like Save the
Children find themselves trying to rebuild sanitation systems. The WHO says
about 2 billion people globally lack access to clean water.

Vaccine
available

Vaccines can
help. Adalja said the oral vaccines the WHO uses to manage cholera outbreaks
have about a 65 percent effectiveness rate over five years. He adds that “65
percent isn’t 100 percent, but it is very good.” Hartness said in order to end cholera in
Yemen, the war that Yemen has been mired in for three years has to end. “In order to
really look at ending this outbreak, we have to look at ending the war,” he
said. “And if that can’t happen immediately, we have to look at negotiating
access to these communities ... that are the hardest to reach.”

Adalja added,
“It’s basically a poverty trap for some of those countries which they can never
get out of. ... This is something that can be fixed by development and the
civilizing effect of sanitation.” Forty-seven countries are affected by
cholera, and the WHO expects the global cholera situation to get worse, which
is behind its urgency to end the disease.